Sleep Medicine –
Why Aren’t You Sleeping?

If you aren’t sleeping, or aren’t sleeping well, you are not alone! More than 40 million American’s suffer from a sleep disorder, and you might not be sleeping because you have a sleep disorder.

Sleep disorders are characterized by disturbance in the amount of quality or timing of sleep, or in behaviors or physiological conditions associated with sleep. Sleep disorders may be persistent, cause significant emotional distress, and interfere with social or occupational functioning.

You can learn more about sleep disorders on this web site and also learn about Pediatric Sleep, Teen Sleep, and tips to improve your sleep through Sleep Hygiene. If you believe you or loved one has a sleep disorder, please don’t delay. Call us at 314-645-5855 and ask for more information or to schedule a consultation.

Sleep disorders are serious, often under-diagnosed, can be life-threatening and are very treatable.

The professional sleep specialists at CSI have years of experience and success in treating patients with sleep disorders. We will take your condition seriously and treat you with care because our goal is for you to achieve health and wellbeing. At Clayton Sleep Institute, we know that better sleep means better life.

Do you have a sleep disorder?

Obstructive Sleep Apnea

More than 18 million Americans—approximately one in twenty-five people—suffer from sleep apnea. In obstructive sleep apnea, a serious medical disorder, the sleeper’s breathing is repeatedly interrupted—for more than 10 seconds and sometimes up to a minute. These interruptions occur because the sleeper’s throat “collapses” and obstructs the airway. The definition of apnea is “lack of breath.” The sleeper’s apneic breathing—the interruptions—can occur five-to-thirty times per hour, or more!

Left untreated, obstructive sleep apnea can result in high blood pressure, heart attack, congestive heart failure, atrial fibrillation and stroke, and worsen diabetes.

Individuals with the following characteristics or symptoms are at higher risk for obstructive sleep apnea:

Men with a neck size of 17 inches or more

Women with a neck size of 16 inches or more

High blood pressure

Age 65 or older

Chronic snoring

Excessive daytime sleepiness

Other symptoms include difficulty concentrating, excessive daytime sleepiness, irritability, depression, sexual dysfunction, learning and memory problems and falling asleep at the wheel or at work.

Sleep apnea can be life-threatening and is often under-diagnosed. If you think you or a loved one have sleep apnea, please consult a medical professional.

Insomnia

According to the National Sleep Foundation, 10-15% of adult American report chronic insomnia—that is, the inability to fall asleep, remain asleep or get adequate restorative sleep for more than one month. Or when there is a repeating pattern of poor sleep for several nights, followed by adequate sleep for a few nights, and then a return to poor sleep for a few nights—this is chronic intermittent insomnia.

Without question, insomnia can profoundly and adversely affect performance, quality of life and wellbeing. In addition to excessive daytime sleepiness, impaired cognitive function and irritability, insomnia may lead to depression or other mood disorders, contribute to automobile accidents and may suppress the immune system. People suffering from insomnia often do not seek help or professional treatment and may try a range of over-the-counter aids or self-medicate to try to address the insomnia. Often, these tactics don’t work and may actual worsen the problem.

Typically it is easier to treat Chronic Intermittent Insomnia as opposed to Chronic Insomnia, and the sleep professionals at Clayton Sleep Institute encourage patients to seek professional medical help during the chronic intermittent phase of insomnia.

At the CSI Insomnia Center our sleep professionals can help you. We have a proprietary process for evaluation and diagnosis of insomnia that allows us to develop a personalized plan of treatment. With proper diagnosis, insomnia can be treated successfully and result in a much higher quality of life for the insomnia sufferer.

To schedule a consultation with the staff of The Insomnia Center at Clayton Sleep Institute, call 314-645-5855.

Restless Legs Syndrome and Periodic Limb Movement Disorder

Restless Legs Syndrome (RLS) is a neurological disorder that causes the overwhelming urge to move the legs that is often accompanied by burning, itching, tugging or creeping sensations in the legs. In general, RLS, which can occur at any time, starts or becomes worse when the person is at rest or lying down. RLS can cause difficulty falling asleep or staying asleep and the lack of high quality, restorative sleep can exacerbate the RLS symptoms and have a serious impact on health and quality of life.

As much as 10% of the U.S. population may have RLS. Some studies show that moderate to severe RLS affects approximately 2-3% of adults or more than 5 million people. Childhood RLS is estimated to affect almost 1 million school-age children, with one-third having moderate to severe symptoms. RLS occurs in both men and women, although the incidence is about twice as high in women. It may begin at any age. Many individuals who are severely affected are middle-aged or older, and the symptoms typically become more frequent and last longer with age.

More than 80% of people suffering from RLS also experience a condition called Periodic Limb Movement in Sleep or may be diagnosed with Periodic Limb Movement Disorder, which is the involuntary, repetitive movement of limbs during sleep that cause sleep disruption. RLS and PLMD do not always occur in the same individual.

The twitching or jerking movements of PLMD typically occur every 15 to 40 seconds, sometimes throughout the night. The symptoms cause repeated awakenings and severely disrupted sleep. The lack of sleep or of restorative sleep can result in daytime sleepiness, fatigue, irritability and mood disorders.

RLS and PLMD are often treatable with a combination of modified lifestyle and medications. It is important for anyone who suspects they may have RLS or PLMD to consult medical professionals and get a proper diagnosis and plan of treatment.

CSI sleep professionals can develop a treatment program for patients suffering from RLS or PLMD that will increase restorative sleep and improve wellbeing. As needed, CSI will work closely with the patient’s primary care physician, neurologist or other specialist physician to develop an optimum overall program.

Sleep Phase Syndrome-Or Circadian Rhythm Disorders

Circadian rhythm sleep disorders are a family of sleep disorders that affect the timing of sleep and wake periods required for normal social needs.

Some sleep phase challenges are caused by external circumstances, such as Jet Lag and Shift Work Sleep Disorder.

Some sleep phase disorders are caused by internal issues for each individual that might be hormonal, age-related, genetic predispositions or other elements. Of these, Delayed Sleep Phase syndrome is a pattern, lasting more than three months, of delay of two hours or more from the desired time to fall asleep, which results in the inability to wake up at the desired time. Advanced Sleep Phase syndrome is the pattern of being very sleepy in the early evening—from 6:00 – 8:00pm—and going to sleep which results in very early awakening times (1:00 – 3:00am). Other sleep phase disorders include shifting sleep-wake cycles that move consistently forward in the 24-hour cycle and irregular sleep-wake rhythm where sleep occurs at very irregular times.

Most important for Sleep Phase disorders is the proper diagnosis so an appropriate plan of treatment can be designed for the specific individual. Not treating Sleep Phase Disorders can severely affect quality of life, and with lack of sleep over time, can contribute to serious health issues such as heart attack and stroke.

Please call the Clayton Sleep Institute at 314-645-5855 and ask to speak to a specialist for Sleep Phase Disorder.

Narcolepsy

Narcolepsy is a sleep disorder defined by excessive sleepiness and the tendency to fall asleep at inappropriate times. Typically, an individual with narcolepsy suffers “sleep attacks” as well as continual sleepiness that is not relieved by any amount of sleep.

Other symptoms may include sudden loss of muscle strength, the inability to move when waking or falling asleep, vivid and often frightening dreams that occur when the person is drowsy and disturbed nighttime sleep.

If not identified and appropriately managed, narcolepsy can drastically affect wellbeing with devastating results.

At Clayton Sleep Institute we can evaluate your condition, perform sleep tests that help diagnose narcolepsy and develop a treatment plan for you to manage yourself and your environment and improve you quality of sleep and life. If you are suffering from the symptoms of narcolepsy, please call us at 314-645-5855 and ask for a consultation.

Pediatric Sleep

We would all like for sleep to be the most natural thing in the world, but sometimes children have serious sleep issues and even sleep disorders. According to a poll by the National Sleep Foundation, 69% of children experience one or more sleep problems at least a few nights per week. A number of scientific studies have indicated a correlation in children between sleep disorders and mood, behavior and learning difficulties—even bullying!

Good sleep for children is a foundation for good health, good development and good habits throughout life.

Things to watch for as signs or symptoms of sleep disorder in your child:

Nighttime:

Snoring, noisy breathing, pauses in breathing

Teeth grinding

Difficulty waking in the morning

Frequent awakenings

Difficulty falling asleep

Sleep walking, talking or other unusual behaviors

Enuresis (bedwetting)

Daytime:

Falling asleep in class

Poor concentration

Hyperactivity

Irritability

Growth or developmental delays

Mood changes

Increased accidents or injuries

Behavior problems

Of particular concern is pediatric sleep apnea, a condition where a child’s upper airway narrows during sleep and causes interrupted breathing and interrupted sleep. Pediatric sleep apnea is often undiagnosed and can be life threatening; at the very least it can lead to serious mental and physical developmental issues. It may be caused by enlarged adenoids or tonsils, but other conditions such as muscle weakness, overweight and head or facial abnormalities may cause sleep apnea in children.

If your child suffers from persistent sleep issues, it’s time to consider seeking professional help. Clayton Sleep provides treatment for sleep disorders in children ages two and older and will coordinate all care with your pediatrician. But remember, you don’t need a doctor’s referral for a sleep assessment for your child. The sleep professionals at CSI welcome your calls at 314-645-5855. We will help your child achieve better sleep.

Teen Sleep

So what’s going on with my teen and sleep?

Older children and teens commonly have sleep disorders that are undiagnosed and untreated. Sleep disturbances may occur in up to 30% of children and “body clock” delays may occur in more than 10% of teens. Sleep disorders range from inadequate amount of sleep and poor quality sleep to insomnia, sleepwalking, sleep apnea, restless leg syndrome and narcolepsy.

Teenagers and older children may suffer from a simple lack of sleep. Teens need between 8 — 10 hours of sleep per night; children between age five and twelve require between 10 – 11 hours of nightly sleep. By comparison, adults need 7 – 9 hours of sleep per night. A household with adults, teens and small children is automatically set to have conflicting sleep needs by the individual members of the family.

Teens, at puberty, begin to experience a delay in the phases of their body clocks. Because of this delay, they fall asleep later in the evening, and in turn, find it more difficult to wake up in time for school. Research shows that this delay is related to hormonal changes that are age related.

Sleep disorders for teenagers and older children can result in inability to get up on time, daytime moodiness, irritability, lack of focus and marked behavioral and learning challenges. A particular concern for teens is drowsy driving or impaired function behind the wheel of a vehicle. Some sleep disorders cause serious threats to a teenager’s health, including cardiovascular and metabolic issues.

Sleep disorders arise from a variety of sources. Some of genetic predispositions, some are transitional and will go away with time, some of exacerbated by diet and environment, for example, over consumption of caffeine or excessive use of cell phones or gaming electronics. Testing may include a sleep study and treatment may be behavioral techniques, coaching for improved sleep hygiene, a customized C-PAP device to keep air flowing during sleep or other strategies for improving quality and quantity of sleep.

If your teenager is experiencing persistent or extreme sleep difficulties, it’s time to see a medical professional. The sleep specialists at Clayton Sleep Institute can provide the testing, diagnosis and plan of treatment your teen or older child may need—tailored specifically to him or her. Please give us a call at 314-645-5855 to schedule a sleep consultation for you and your teen.

Sleep Hygiene

Sleep “hygiene” is simply behaviors and habits in everyday life that affect the quality and quantity of sleep. There are certain lifestyle and dietary habits that promote sound sleep and most of them are common sense, but it is easy to slip out of positive patterns and into choices that adversely affect your health.

How Does Stress Affect Sleep?

Stress causes many sleep problems. If you find that stress causes you trouble in sleeping, you may begin to develop certain habits—such as regular napping, overuse of caffeine, use of alcoholic beverages at bedtime, working at night or sleeping at irregular times—to help you cope with the lack of regular sleep. And when the stress goes away, the poor sleeping habits stay on!

Some people develop a cycle of repeated difficulty falling asleep and a lot of worry about being able to fall asleep. Even your bedroom may become associated with “the place I can’t sleep” and you end up trying to sleep in a chair or on the sofa. Setting and keeping a good pattern for sleep will help you weather the effects of stress. Setting aside time before bed to do something relaxing—light reading, listening to music, a warm bath—can help your mind and your body let go of stress and get ready for sleep. Relaxation techniques such as meditation can also be beneficial, as is a program of exercise as long as it is not close to your bedtime.

How Do Caffeine, Nicotine and Alcohol Affect Sleep?

Caffeine, nicotine and alcohol are all common sources of problems for good sleep. Even how much and when you eat can affect your sleep.

Caffeine in coffee, tea, colas, chocolate, energy drinks and even in some prescription medicines stimulates the brain. Moderate daytime consumption does not usually interfere with sleep, but withdrawal from heavy use of caffeine will impact sleep. If you suffer from insomnia, do not drink more than two caffeinated beverages a day, and only before noon.

Nicotine also stimulates the brain and disrupts sleep for many people because of awakening during regular sleep hours. For most people, kicking the habit—not smoking or “dipping”—will result in falling asleep faster and waking up fewer times during the night.

While alcohol slows down brain activity and may induce sleep at bedtime, it will disrupt sleep later in the night. People who use alcohol to fall asleep suffer from frequent awakening during the night, nightmares and early morning headaches. For better quality sleep, don’t drink alcoholic beverages within four to six hours before bedtime.

A heavy meal close to bedtime, or foods that cause upset stomach, will interfere with many people’s ability to fall asleep and stay asleep. A light snack at bedtime can help promote sleep, and milk or other dairy products combined with a complex carbohydrate like a whole grain cracker are especially good as bedtime snacks.

Electronic Devices and Screens

Electronic devices and the light from their screens can, and often do, interfere with good sleep habits for everyone, but especially for teens and young adults. First, there is simply the habituated interruption of checking texts, email and social media—a very negative behavioral modification that impacts daily life for most “wired” individuals. The CSI sleep experts recommend keeping all electronic communications and entertainment devices—including televisions!—out of the bedroom.

Second, we know that the blue light wave length emitted by virtually all electronic device screens affects the hypothalamus and delays the sleep-inducing hormone melatonin. Essentially, we trick our brain into thinking it’s daytime. There are a number of strategies to offset the impact of blue light from using devices within two hours of going to bed, from glasses with yellow lenses to built-in screen light color control on some devices. So far, the only proven technique is to stop using blue-light emitting devices at least two hours before you go to sleep.

So What Else Affects My Sleep?

Where you sleep matters. A comfortable bed in a quiet, cool, dark room is the best for a good night’s sleep. Some people are very sensitive to light and need to be sure natural and artificial light are dimmed or removed. Noise is also an issue for some people and they can benefit from ear plugs, “white noise” machines or even the hum of a fan. If you are a clock watcher, set an alarm and then remove it from your sight so you do not increase pressure on yourself to fall asleep. The point is to sleep without pressure or interference from your environment.

Regular exercise helps encourage better sleep. It is important not to exercise strenuously within six hours of your bedtime because it may disrupt your sleep. Light exercise and adequate daytime activity are very important for sound sleep, so if you are office bound, be sure to consider a program of regular exercise.

Tips for Good Sleep Hygiene

Try to sleep only when you are drowsy

If you are unable to fall asleep or stay asleep, leave your bedroom and engage in a quiet activity elsewhere—don’t fall asleep outside the bedroom! Go back to bed when you are sleepy. Repeat this process as often as necessary throughout the night.

Maintain a regular schedule—wake up and go to bed at the same time even on weekends and vacations.

Your bedroom is for sleep, sex and when you are sick.

Avoid daytime napping. If you are overwhelmed by sleepiness during the day, limit yourself to one nap of less than an hour before 3:00pm.

Distract your mind—avoid lying in bed when you are unable to sleep. Try reading, listening to light music or audio books or other activity outside of your bedroom. Go back to bed when you are drowsy.

Avoid caffeine within four to six hours before bedtime and before noon if you have trouble with insomnia.

Kick the nicotine habit—or at the very least avoid nicotine close to bedtime or during the night.

Don’t drink alcoholic beverages within four to six hours before bedtime.

Avoid large meals before bedtime and consider a light snack that features a dairy product and a complex carbohydrate such as cheese and wholegrain crackers.

Avoid strenuous exercise within six hours of bedtime.

Minimize light, noise and extremes in temperature in the bedroom.

If you suffer from sleeplessness for four to six weeks even though you have modified your sleep and daytime habits, it’s time to consider seeking professional help. The sleep professionals at CSI welcome your calls at 314-645-5855. We will help you achieve the sleep you need for your personal wellbeing.